Global Mortality From Firearms, 1990-2016.

Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions. Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. Design, Setting, and Participants: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. Exposures: Firearm ownership and access. Main Outcomes and Measures: Cause-specific deaths by age, sex, location, and year. Results: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P < .001; R2 = 0.21) and homicide (P < .001; R2 = 0.35). Conclusions and Relevance: This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study.

Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. Conclusions and Relevance: Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

Simultaneous CT-MRI Reconstruction for Constrained Imaging Geometries Using Structural Coupling and Compressive Sensing.

OBJECTIVE: A unified reconstruction framework is presented for simultaneous CT-MRI reconstruction. METHODS: In an ideal CT-MRI scanner, CT and MRI acquisitions would occur simultaneously, and would be inherently registered in space and time. Alternatively, separately acquired CT and MRI scans can be fused to simulate an instantaneous acquisition. In this study, structural coupling and compressive sensing techniques are combined to unify CT and MRI reconstructions. A bidirectional image estimation method was proposed to connect images from different modalities. Hence, CT and MRI data serve as prior knowledge to each other for better CT and MRI image reconstruction than what could be achieved with separate reconstruction. SIGNIFICANCE: Combined CT-MRI imaging has the potential for improved results in existing preclinical and clinical applications, as well as opening novel research directions for future applications. RESULTS: Our integrated reconstruction methodology is demonstrated with numerical phantom and real-dataset-based experiments, and has yielded promising results.

Study of scan protocol for exposure reduction in hybrid spectral micro-CT.

The hybrid spectral micro-computed tomography (CT) architecture integrates a conventional imaging chain and an interior spectral imaging chain, and has been proven to be an important development in spectral CT. The motivation for this study is to minimize X-ray exposure for hybrid spectral micro-CT using both simulated and experimental scan data while maintaining the spectral fidelity of the reconstruction. Three elements of the hybrid scan protocol are investigated: truncation of the interior spectral chain and the numbers of projections for each of the global and interior imaging chains. The effect of these elements is quantified by analyzing how each affects the reconstructed spectral accuracy. The results demonstrate that there is significant scope for reduction of radiation exposure in the hybrid scan protocol. It appears decreasing the number of conventional projections offers the most potential for exposure reduction, while further reduction is possible by decreasing the interior FOV and number of spectral projections.

Hybrid spectral micro-CT: system design, implementation, and preliminary results.

Spectral CT has proven an important development in biomedical imaging, and there have been several publications in the past years demonstrating its merits in pre-clinical and clinical applications. In 2012, Xu reported that near-term implementation of spectral micro-CT could be enhanced by a hybrid architecture: a narrow-beam spectral "interior" imaging chain integrated with a traditional wide-beam "global" imaging chain. This hybrid integration coupled with compressive sensing (CS)-based interior tomography demonstrated promising results for improved contrast resolution, and decreased system cost and radiation dose. The motivation for the current study is implementation and evaluation of the hybrid architecture with a first-of-its-kind hybrid spectral micro-CT system. Preliminary results confirm improvements in both contrast and spatial resolution. This technology is shown to merit further investigation and potential application in future spectral CT scanner design.

Characterizing property distributions of polymeric nanogels by size-exclusion chromatography.

Nanogels are highly branched, swellable polymer structures with average diameters between 1 and 100nm. Size-exclusion chromatography (SEC) fractionates materials in this size range, and it is commonly used to measure nanogel molar mass distributions. For many nanogel applications, it may be more important to calculate the particle size distribution from the SEC data than it is to calculate the molar mass distribution. Other useful nanogel property distributions include particle shape, area, and volume, as well as polymer volume fraction per particle. All can be obtained from multi-detector SEC data with proper calibration and data analysis methods. This work develops the basic equations for calculating several of these differential and cumulative property distributions and applies them to SEC data from the analysis of polymeric nanogels. The methods are analogous to those used to calculate the more familiar SEC molar mass distributions. Calibration methods and characteristics of the distributions are discussed, and the effects of detector noise and mismatched concentration and molar mass sensitive detector signals are examined.

Study of an adaptive bolus chasing CT angiography.

To improve imaging quality and to reduce contrast dose and radiation exposure, an adaptive bolus chasing CT angiography was proposed so that the bolus peak position and the imaging aperture can be synchronized. The performance of the proposed adaptive bolus chasing CT angiography was experimentally evaluated based on the actual bolus dynamics. The experimental results show that the controlled table position and the bolus peak position were highly consistent. The results clearly demonstrate that the proposed adaptive bolus chasing CT angiography that synchronizes the bolus peak position with the imaging aperture by a simple adaptive system is computationally and clinically feasible. Similar techniques may also be applied to conventional angiography to improve imaging quality and to reduce contrast dose and/or radiation exposure.